Doctor Without Borders

Javid Abdelmoneim (1997)

One OPs journey from The Perse to the Front Line.

On Friday 1 December 2017, Javid Abdelmoneim (1997) returned to The Perse to deliver a 42 Lecture to current students.

The last time Javid had spoken in the Perse lecture theatre was for a third form English presentation, in which he failed to deliver the dramatic ending had intended, and accidentally reduced the audience to fits of laughter. More than two decades on, his next talk in the lecture theatre could not have been more different, leaving us with a message of hope despite the desperate medical need in many parts of the world.

After leaving The Perse in 1997, Javid went to study medicine at UCL, and he is now an accident and emergency doctor. Alongside his NHS and television work, he has worked in the field for Médecins Sans Frontières (MSF) six times, alongside being their UK President. The charity’s mission is to deliver medical aid in a way that is neutral, impartial and independent of government. Its doctors decide who to treat solely on medical grounds, regardless of the patient’s nationality or political affiliations.

Médecins sans Frontières is able to provide medical treatment in parts of the world where no-one else can go, using transport methods as diverse as canoes, mopeds, donkeys and helicopters to get doctors and other professionals into the field. They focus their operations on parts of the world affected by armed conflict, epidemics, malnutrition, natural disasters and populations excluded from healthcare. Sometimes people are excluded from healthcare for political reasons, such as the tribes Javid worked with in South Sudan. They were not given citizenship of this new country, and as a consequence they do not have access to healthcare. Furthermore, when crops failed after being neglected in the civil war, UN food packages were not sent out to them. Helping people like this on the ground takes careful organisation as well as compassion. The roads to these communities are impassable in the rainy season, so the only way to access them is by helicopter. Each helicopter can only take 1000kg, including the doctors and nurses themselves, so with several people on board, there might only be around 700kg left over for medical supplies, food, water, tents and everything else required to live and work in the field for five days at a time. Once they arrive, MSF staff set up a circuit for people to queue and a waiting area, usually under a tree in a hot environment like South Sudan, where patients can be weighed and receive an initial assessment.

The medical problems Javid encounters in an area like South Sudan can vary from diarrhoea to malaria to serious injuries. He told us the story of Kero, a young boy who received an accidental shot to the chest while herding cows. MSF took him and his mother from their remote community to the UN camp in the capital city for life-saving surgery. The surgeon initially operated on the wrong side of his chest, showing that the doctors are not infallible. Eventually, he received the treatment he needed, and when Javid flew into the field he took Kero and his mother back to their village. Not all cases are as extreme as Kero’s, and there are many basic technologies adopted by MSF that have saved countless lives. Javid showed us a simple ring of card, which looked like a bracelet coloured in green, yellow and red. This is wrapped around a child’s upper arm to measure its circumference, and consequently how underweight the child is. The colour coding means that members of the local community can use it without needing to be able to read, allowing them to send the children suffering from malnutrition to MSF staff for treatment. When a child is identified as suffering severe acute malnutrition, they are often given ‘Plumpy’Nut’, a peanut-based paste rather like peanut butter enclosed in a plastic wrapper. This is easy for parents and carers to administer at home, removing the need for hospitalisation and allowing doctors to treat many more malnourished children.

While Javid was in South Sudan in the spring of 2014, the Ebola crisis struck in West Africa. The unprecedented nature of the epidemic became apparent when one of the nurses he was working with, who was a specialist in treating patients with diseases like Ebola, was sent straight to Guinea halfway through the project. The scale of the crisis meant that the usual MSF procedure of seeing a project through to its conclusion, and only beginning a new one after a rest period, had to be abandoned. Previously, Ebola had usually been found in remote areas, but in 2014 it spread through huge urban areas, affecting hundreds of thousands of people, rather than the hundreds medical professionals were used to dealing with in previous outbreaks. By the end of the summer, Javid had gone out to West Africa himself, where he found himself having to adapt the nature of his medical treatment to these new, catastrophic conditions. Usually, his role was to try to cure people but, in the absence of a cure, all medical professionals could do for the Ebola patients was to give them comfort in their suffering and hope they would full through. Javid showed us a picture of his youngest survivor, a baby girl who survived after three and a half weeks in hospital. Both her parents died, and at several points it seemed likely that she would also fall victim to the disease. In the photograph, Javid is holding the little girl without the protective clothing he had to wear when treating patients. It was crucial for communities to see medical professionals touch survivors without any protection to let them know that the person was no longer contagious, so that survivors were not ostracised once they returned to their communities.

Closer to home, Javid has also worked on search and rescue missions in the Central Mediterranean. Many of those attempting to cross the open ocean are escaping persecution in Libya, where there is a slave trade and many black people suffer racial abuse. Therefore, not only are MSF staff treating injuries received during the crossing, but many patients have experienced terrible violence and sexual abuse before they began their voyage. The MSF mission is based out of a ship called the Aquarius, and the team go out on two smaller boats to ‘sandwich’ the migrants’ boats between them. They equip the migrants with life jackets and ferry them back to the main ship, beginning with the most vulnerable such as children and pregnant women. Around 17% of the migrants attempting this perilous crossing are children of a similar age to those gathered in The Perse’s lecture theatre to hear Javid’s talk.
During questions, Javid admitted that his lecture had often painted a gruesome picture of the world, and his role as an MSF doctor had put him face-to-face with cruelty, violence and injustice. He was asked how he coped with this, and acknowledged that it was difficult as a doctor to provide compassionate care, without shutting himself off emotionally from his patients, while protecting his own mental health. MSF recognises this risk, and provides psychological support for its staff. Javid finds that he can cope better with the potentially overwhelming suffering he encounters by using his work to relate to patients as a person, not simply as a doctor. Whatever has happened in the patient’s past, or what their future may hold, in the moment they are with him they are cared for and safe.

Alleviating another person’s suffering in a moment of need is something all of us can do to make the world a better place, and Javid gave Perse pupils a powerful example of the life-changing impact of combining compassion and hope with education and expertise. His work embodies the Perse values of caring for one another, endeavour and intellectual curiosity, and we were delighted to welcome him back to his old school.

Listen to Javid talk about how he got involved with MSF, what he finds rewarding about such work, and his advice to students considering helping the cause in the future.